| NPI | 1578016044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2007) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MN 10499) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2019-08-21 |